出国医疗

单药维持治疗非小细胞肺癌:系统回顾和荟萃分

来源:万方数据库    时间:2013-11-15 11:16  浏览次数:

Single-agent maintenance therapy in non-small cell lung cancer: a systematic review and meta-analysis
                        单药维持治疗非小细胞肺癌:系统回顾和荟萃分析


    Abstract:Background Can single-agent maintenance therapy be considered as an ideal strategy for non-small cell lung cancer (NSCLC) treatment to achieve prolonged survival and tolerated toxicity? A systematic review and meta-analysis was performed to elucidate this issue.Methods The electronic databases were searched for RCTs comparing single-agent maintenance therapy with placebo,best support care or observation.The required data for estimation of response,survival and toxicity were extracted from the publications and the combined data were calculated.Results Eleven RCTs involving 3686 patients were identified.We found a statistically significant higher probability of tumor response for patients with maintenance therapy versus control patients (OR:2.80,95% CI:2.15-3.64).Patients receiving maintenance therapy had significantly longer progression-free survival (PFS) (HR:0.67,95% CI:0.62-0.71)and overall survival (OS) (HR:0.84,95% CI:0.78-0.90).However,maintenance therapy was associated with more severe toxicities (OR:6.45,95% CI:4.61-9.01).Conclusion In patients with advanced NSCLC,the use of single-agent maintenance therapy is associated with higher response rate and significantly prolongs PFS and OS despite of the risk of additional toxicity.
   摘要:提高生存时间和耐药性 ,单药维持治疗非小细胞肺癌被认为是理想的方法?系统回顾和荟萃分析阐述这个问题。开发方法电子数据库搜索临床数据进行对比,这些数据记录单药维持治疗及辅助药,最佳照顾及观察。
   从出版物和综合资料 获取所需资料来评估效应,生存率,及药物毒性。11项临床试验涉及3686患者。我们发现维持治疗的患者获得明显的疗效(OR:2.80,95% CI:2.15-3.64)。患者应用维持疗法大大获得无限生存时间(HR:0.67,95% CI:0.62-0.71)及更长总生存时间(HR:0.84,95% CI:0.78-0.90)。但是维持治疗毒性更大(OR:6.45,95% CI:4.61-9.01).结论应用单一维持治疗的晚期非小细胞肺癌患者对药反应增加,生存率显著增加及总生存时间增长但是药物毒性增加。



 

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